Senior Claims Assessor - Personal Lines

Placements24; Midrand; Hybrid; ZAR 480,000 - 720,000; Full time

Benefits offered by this job

Competitive remuneration

Annual bonus

Medical aid

Provident fund

Professional development funding

Hybrid work model

Wellness programs

Job summary

Placements24 is seeking a highly experienced Senior Claims Assessor for our client in Midrand, Gauteng. The role focuses on processing personal lines insurance claims accurately, mentoring junior staff, and driving process improvements.

You will assess complex claims, gather documentation, liaise with policyholders and service providers, determine liability and reserves, and ensure compliance with SA regulations.

Qualifications

• Relevant tertiary qualification (e.g., B.Com, LLB or equivalent).
• Minimum 5 years of demonstrable personal lines claims experience in the SA market.
• Proficiency in relevant insurance software and claims management systems.
• Strong knowledge of SA insurance legislation and regulations.
• Excellent analytical, problem-solving and decision-making skills.
• Exceptional communication, negotiation and interpersonal abilities.
• Experience mentoring or supervising junior staff is advantageous.
• Must be based in or willing to commute to Midrand with a hybrid work arrangement.

Responsibilities

• Investigate, assess and adjudicate complex personal lines claims.
• Gather and analyze incident reports, policy details and repair estimates.
• Communicate with policyholders, intermediaries and service providers for updates.
• Determine liability, coverage and reserve requirements for assigned claims.
• Negotiate and authorize settlements within defined authority limits.
• Identify fraud indicators and escalate suspicious claims for investigation.
• Mentor junior claims assessors and foster a collaborative team environment.
• Contribute to development of best practices and process improvements.
• Ensure compliance with regulatory requirements and company policies.

Skills

Analytical thinking

Problem solving

Decision making

Communication

Negotiation

Interpersonal skills

Mentoring

Education

B.Com

LLB

Tools

Claims management systems

Insurance software

Job description

About the Role

Our client, a leading player in the insurance sector, is seeking a highly experienced and detail-oriented Senior Claims Assessor to join their dynamic team in Midrand, Gauteng . This role is pivotal in ensuring the efficient and accurate processing of personal lines insurance claims, upholding the company's commitment to exceptional customer service and fair settlements. The successful candidate will leverage their extensive industry knowledge to mentor junior staff and contribute to process improvement initiatives. This is a fantastic opportunity to advance your career within a reputable organization that values expertise and professional growth.

Key Responsibilities

• Investigate, assess, and adjudicate complex personal lines insurance claims in accordance with policy terms and conditions.
• Gather and analyze all relevant documentation, including incident reports, policy details, and repair estimates.
• Communicate effectively with policyholders, intermediaries, and service providers to obtain necessary information and provide claim status updates.
• Determine liability, coverage, and reserve requirements for assigned claims.
• Negotiate and authorize claim settlements within defined authority limits.
• Identify potential fraud indicators and escape suspicious claims for further investigation.
• Mentor and provide guidance to junior claims assessors, fostering a collaborative team environment.
• Contribute to the development and implementation of claims handling best practices and process improvements.
• Ensure compliance with all relevant regulatory requirements and company policies.

Requirements

• A relevant tertiary qualification (e.g., B.Com, LLB, or equivalent).
• A minimum of 5 years of demonstrable experience in personal lines claims assessing within the South African insurance market.
• Proficiency in relevant insurance software and claims management systems.
• Strong understanding of South African insurance legislation and regulations.
• Excellent analytical, problem-solving, and decision-making skills.
• Exceptional communication, negotiation, and interpersonal abilities.
• Proven ability to manage a diverse caseload efficiently and effectively.
• Experience in mentoring or supervising junior team members is highly advantageous.
• Must be based in or willing to commute to Midrand, Gauteng , with a hybrid work arrangement.

Benefits

• Our client offers a competitive remuneration package, including a generous annual bonus structure and comprehensive medical aid and provident fund contributions.
• You will benefit from continuous professional development opportunities, including funding for relevant certifications and further education.
• The company fosters a supportive and collaborative work environment, with opportunities for career advancement within the organization.
• Enjoy a flexible hybrid work model that balances productivity with personal well-being, alongside access to wellness programs and employee assistance services.
• Be part of a team that is dedicated to excellence and innovation in the insurance industry.